Provider Demographics
NPI:1639106693
Name:FIELD, MICHELLE ANN
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANN
Last Name:FIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:887 BOB-O-LINK RD.
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3913
Mailing Address - Country:US
Mailing Address - Phone:847-433-9268
Mailing Address - Fax:847-266-1931
Practice Address - Street 1:887 BOB-O-LINK RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3913
Practice Address - Country:US
Practice Address - Phone:847-912-1122
Practice Address - Fax:847-291-1156
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1103772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry